A 48-year-old has severe major depression with nihilistic delusions, auditory accusations, refusal of food and marked psychomotor slowing. She is

Question

A 48-year-old has severe major depression with nihilistic delusions, auditory accusations, refusal of food and marked psychomotor slowing. She is medically stable and agrees to treatment. Which acute treatment is appropriate?

Accepted Answer

Use an antidepressant plus an antipsychotic or offer electroconvulsive therapy

Answer

Use a stimulant alone to reverse psychomotor slowing and poor intake

Answer

Use outpatient supportive therapy alone before considering somatic treatment

Answer

Use antipsychotic monotherapy and avoid antidepressant treatment

Answer

Use SSRI monotherapy because psychotic symptoms resolve only after mood improves

SSRI sexual adverse effect — USMLE Step 3 MCQ

A 48-year-old has severe major depression with nihilistic delusions, auditory accusations, refusal of food and marked psychomotor slowing. She is medically stable and agrees to treatment. Which acute treatment is appropriate?